Pelvic exenteration of gynecologic malignancy: Indications, and technical and reconstructive considerations

Pelvic exenteration, whether for palliation or resection of primary or recurrent gynecologic cancer, is reserved for a highly specific group of patients. When performed appropriately, it may offer a marked improvement in survival and quality of life for these women. The variations in exenterative procedures discussed can offer tailored excision of disease while preserving selected organs and their function to minimize changes in lifestyle. Resection of the pelvic viscera and reconstruction of functional urinary and intestinal diversions can be technically challenging for surgeons and physically and emotionally demanding for patients. Appropriate patient selection and novel techniques have reduced complications and patient morbidity and improved quality of life for these patients.